Integrated cardiovascular/respiratory control in type 1 diabetes evidences functional imbalance : Possible role of hypoxia

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Bianchi , L , Porta , C , Rinaldi , A , Gazzaruso , C , Fratino , P , DeCata , P , Protti , P , Paltro , R & Bernardi , L 2017 , ' Integrated cardiovascular/respiratory control in type 1 diabetes evidences functional imbalance : Possible role of hypoxia ' , International Journal of Cardiology , vol. 244 , pp. 254-259 . https://doi.org/10.1016/j.ijcard.2017.06.047

Title: Integrated cardiovascular/respiratory control in type 1 diabetes evidences functional imbalance : Possible role of hypoxia
Author: Bianchi, L.; Porta, C.; Rinaldi, A.; Gazzaruso, C.; Fratino, P.; DeCata, P.; Protti, P.; Paltro, R.; Bernardi, L.
Contributor: University of Helsinki, Department of Medical and Clinical Genetics
Date: 2017-10-01
Language: eng
Number of pages: 6
Belongs to series: International Journal of Cardiology
ISSN: 0167-5273
URI: http://hdl.handle.net/10138/298258
Abstract: Background: Cardiovascular (baroreflex) and respiratory (chemoreflex) control mechanisms were studied separately in diabetes, but their reciprocal interaction (well known for diseases like heart failure) had never been comprehensively assessed. We hypothesized that prevalent autonomic neuropathy would depress both reflexes, whereas prevalent autonomic imbalance through sympathetic activation would depress the baroreflex but enhance the chemoreflexes. Methods: In 46 type-1 diabetic subjects (7.0 +/- 0.9 year duration) and 103 age-matched controls we measured the baroreflex (average of 7 methods), and the chemoreflexes, (hypercapnic: ventilation/carbon dioxide slope during hyperoxic progressive hypercapnia; hypoxic: ventilation/oxygen saturation slope during normocapnic progressive hypoxia). Autonomic dysfunction was evaluated by cardiovascular reflex tests. Results: Resting oxygen saturation and baroreflex sensitivity were reduced in the diabetic group, whereas the hypercapnic chemoreflex was significantly increased in the entire diabetic group. Despite lower oxygen saturation the hypoxic chemoreflex showed a trend toward a depression in the diabetic group. Conclusion: Cardio-respiratory control imbalance is a common finding in early type 1 diabetes. A reduced sensitivity to hypoxia seems a primary factor leading to reflex sympathetic activation (enhanced hypercapnic chemoreflex and baroreflex depression), hence suggesting a functional origin of cardio-respiratory control imbalance in initial diabetes. (C) 2017 Elsevier B.V. All rights reserved.
Subject: Chemoreflex
Baroreflex
Diabetic neuropathy
Hypoxia
Autonomic nervous system
Type 1 diabetes
SPONTANEOUS BAROREFLEX SENSITIVITY
OBSTRUCTIVE SLEEP-APNEA
CHRONIC HEART-FAILURE
AUTONOMIC NEUROPATHY
VENTILATORY RESPONSES
OXYGEN-SATURATION
OXIDATIVE STRESS
LUNG-FUNCTION
MELLITUS
ASSOCIATION
3121 General medicine, internal medicine and other clinical medicine
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